Provider Demographics
NPI:1336139690
Name:STRAIGHT, TIMOTHY M (M,D,)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:M
Last Name:STRAIGHT
Suffix:
Gender:M
Credentials:M,D,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2241 NW MILITARY HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-4927
Mailing Address - Country:US
Mailing Address - Phone:210-907-8346
Mailing Address - Fax:210-906-8907
Practice Address - Street 1:2241 NW MILITARY HWY STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-4927
Practice Address - Country:US
Practice Address - Phone:210-907-8346
Practice Address - Fax:210-906-8907
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4132202K00000X, 207N00000X
DCMD32310207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFS8211841OtherDEA REGISTRATION